Useful Info

CHIP Notice

The Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) requires group

health plans to permit employees and dependents who are eligible, but not enrolled for

coverage, to enroll in that coverage when the employees or dependents become eligible

for a premium assistance subsidy under Medicaid or the Children’s Health Insurance Program

(CHIP). Employees who are eligible for health coverage through their employer, but are

unable to afford the premium, may be eligible for premium assistance to help pay for health

coverage. Employees must request this special enrollment within 60 days of the date it is

determined that they, or their dependents, are eligible for premium assistance.

Notice Requirements

CHIPRA requires employers that maintain group health plans in states that provide Medicaid

or CHIP assistance to notify their employees about potential opportunities for premium

assistance subsidies. The Employer CHIP Notice may be used to fulfill the notification

requirement and is now available. A sample notice is attached.

The Employer CHIP Notice must inform employees of premium assistance opportunities

currently available in the states in which the employees live. Because employees may not live

in the state in which the employer, the health plan, its insurer, or other service providers are

located, the sample notice is a national notice that provides information on all states that

offer Medicaid or CHIP assistance.

Employees Entitled to Notice

The notice must be provided to all employees living in premium assistance subsidy states,

including employees not enrolled in the plan. To avoid missing any eligible employees,

employers may want to provide the notice to all employees. Employees covered by

collectively bargained or multi-employers plans must receive the notice.

When and How Notices Must be Provided

Employers must provide employees with the CHIP Notice annually. The initial CHIP notice must

be provided by the later of:

The first day of the first plan year after February 4, 2010; or May 1, 2010.

Calendar-year plans must provide the notice by January 1, 2011.An information brief from the Compliance Division of Benecon.


2010 The Benecon Group, Inc. All Rights Reserved.February 2010


CHIP Notice for Employees Regarding Eligibility for

Premium Assistance

This BeneFlash applies to all employers who maintain group health plans,

Including government and church group health plans




CHIP Notice for Employees Regarding Eligibility

For Premium Assistance

(continued)The notice must be provided in writing in a separate document. However, it may be

delivered with other plan information, such as eligibility information, open enrollment

materials, or the SPD. The notice may be provided by first-class mail or electronically.

Pennsylvania Premium Assistance

Pennsylvania CHIP does not have a premium assistance program at this time. Pennsylvania

Medicaid does have a premium assistance program – the Health Insurance Premium

Payment (HIPP) program. The HIPP program will pay the employer plan premiums if the cost is

lower than the cost of medical assistance for employees and their dependents. More

information on the HIPP program is available at

medicalassistance/doingbusiness/003670053.htm information brief from the Compliance Division of Benecon.



2010 The Benecon Group, Inc. All Rights Reserved.This BeneFlash is provided for informational purposes only and does not constitute legal advice. It contains only a summary

of the applicable legal provisions and does not purport to cover every aspect of any particular law, regulation, or

requirement. Benecon serves employers and producers in Pennsylvania. Information contained in this newsletter is

applicable to federal and Pennsylvania laws and regulations. Depending on the specific facts and location of any situation,

there may be additional or different requirements. Please use this BeneFlash as a guide and not as a definitive

description of your compliance obligations.


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